NEWS-Guided Management of Pulmonary Embolism in Pregnancy With Percutaneous Thrombectomy

Pregnancy-associated pulmonary embolism (PE) represents a rare but life-threatening condition, with limited evidence to guide management. Reperfusion therapy must be carefully balanced against an increased risk of maternal and fetal bleeding complications.

We report a case of a 38-year-old woman at 30 weeks' gestation who presented with acute hypoxemia and was diagnosed with central PE complicated by right ventricular dysfunction. The patient's deterioration, objectively captured by the National Early Warning Score (NEWS), guided a multidisciplinary team decision toward percutaneous thrombectomy. The procedure resulted in rapid hemodynamic improvement and preserved maternal and fetal outcomes.

In pregnancy-associated pulmonary embolism, the optimal management strategy-anticoagulation alone, (local or reduced-dose) thrombolysis, or thrombolysis-free reperfusion-remains uncertain, as does the optimal timing of reperfusion.

This case highlights the potential role of catheter-based thrombectomy as a thrombolytic-free option in selected pregnant patients, particularly when guided by structured risk-assessment tools and multidisciplinary input.